Chapter 6

ANTHROPOMETRIC MEASUREMENTS Of flSHERWOMEN AND PRESCHOOL CHILDREN

K. Dhanapal*, J. Lakshmi", Vijaya Khader*, R.Sathiadhas**, H.Mohamad Kasrm*/o', R.N arelyanekuma r".~, N.S.Sudhakara*** and Femeen,a Hassan ....

Abstract

Anthropometric measurements of height and weight were taken of all fisherwomen and their children. Weight of women was found to be 48.5 kg. Height was found to be 150 cm and their BMI was found to be 21 .3 . forty-nine percentage of the women were normal ,17 % were' below low normal ,10.5 % were mildly malnourished, 4 % were moderately malnourished, and 2.9 % were severely malnourished, on ly 11 5 % were over weight and 4.6 % were obese. Overarl, height of the presenooi children surveyed was found to be 90 em and their overall weight was 12.7 Kg .MaJority ( 41%) of them were in grade-, category of malnutrition,32 % were in normal grades , 19% were in grade -2 category of malnutrition and the remaining were grade -3 category of malnutrition.

Introduction

Anthropometry Is one of the methods used in nutritional assessment. Nutritional anthropometry can be defined as measurement of variation of the physical dimensions and the gross composition of the human body at different age levels and degrees of malnutrition .

Growth retardation may be first response of the body towards nutritional deficiencies ,while appearance of clinical signs may be the final stage .From the public health point of view ,identification of SUb-clinical forms of malnutrition is very important for planning programmes of nutritional intervention so as to prevent such milder cases going into severe forms with consequent risk of high mortality.

The measurements that are selected should be the simplest and quickest to measure and the easiest to reproduce, providing simultaneously maximum information concerning a number of nutrimental problems.

The most commonly used measurements in routine surveys are 1) Body weight, 2) crown heel' length or standing height, 3) mid - upper arm circumference etc.

Methodology

Anthropometric measurements of height and weight were taken on all fisher women and preschool children . (I) ,Height (cm) : It was measured using height rod for women and infantometer for preschool children

respectively

(ii) Weight (kg) : Weight was measured using baby weighing scale for infants, salter spring balance for children between 1 - 2.5 years and bathroom weighing scale for children above 2.5 yeats to 5 years. For adults, the weighing scale was utilized.

• Acharya N .O.Ranga Agricultural University, Hyderabad - 500030 **Central Marine Fisheries Research Institute - Kochi - 682014 *** College of Fish eries, Mangalore, 575 002

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Standards fo r reference ; The heigh I and weight obtained by survey were compared wilh NCHS standards. They were also classified by Gomez Classification using weight for age which Is based on percentage deviation from the medium of the reference standard. Hence based on this class! Icaiion one can distinguish grades of deficit Grade - I (mild) Grade - " (moderate) and Grade - "I ( severe) and normal by establishing arbitrary cut off points. The details of Gomez classification is given below.

~ G om&z class lfie aUofl : for ch Itdren Nutritional Status Grades ot Nutritl.on .

Normal

Grade -I (Mild)

Grade -" (moderate)

> 90% of standard weight for age

75-89% of standard weight for age

60 -74% of standard weight for age

< 60% of standard weight for age Grade - "I (severe)

--~--------------------------------------------------------------~

(i) Body Mass Index ( BMI)

The Body Mass Index ::: Weight in (kg) Height in ( mt)2

was used an indicator of nutritional status for fisher women. Classification of malnutrition by grades of BMI as suggested be James et at (1988) is given below. The prevalence rates of these forms of malnutrition has been found and provided for the fisherwomen by states.

8MI Nutritional grade

<16.00 "I degree - Severe 16.0 -17.0 II degree - Moderate 17.0 - 18.0 I degree - Mild 18.5 - 20.0 Low normal - Low 20.0 -25.0 Normal 25.0 - 30.0 Overweight >30.0 Obese.

Statistical analysis

n le date generated has beell utilized to meet the objectives of the study, Frequency distributions, Mean and Standard Deviations and tests of significance were utilized and the results are prov ded fo r each of the variables studied, Analysis variance, ChiSQuare t.est and multiple comparision T , test procedures were utilized and the results are been provided in the chapters (Visveswara Rao, 1996)

Results and discussion

Anthropometry of women : It was observed that the mean height of the fisher women was found to be 150 cm, weight was found to be 48.3 kg and BMI was 21 . 3.

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Table 1: Mean (SD) of Anthropometric measurements of women

SI.No State Anthropometric measurements Total ranks X-

I Height ( cms) Weight ( kgs) BMI

1 Andhra Pradesh 153° (5.50) 48.0° (06.3) 21.4"(2.9) 5.0 T.7 2 Karnataka 151 u (5.20) 47.1° (05.7) 20S (7.6) 1 e.Q 3.3

3 Kerala 149~ (3.00) 47.3" (03.5) 21 .0"U(1.1) 9.5 ~. 2

4 Tamilnadu 149v (8.00) 52 .0" (13 .0) 22.6"(5.3) 6.5 1,8

5 Mean :!:... SD 150.9±7.23 49.2+ 9.17 21.6± 4.67

6 'F' ratio between 'Ir * * * * '/I 'IIO! 'Ii' 'It

states (d.f) 42.05 (3,1534) 27.68 (3,1534) 13.68 (3,1534)

7 Expected Height & 163.7 i 56.6 18.5 - 2.5

Weight * I (Normal)

Note: 1. All the 'F' ratios are significant (* * * p<0.001) 2. Variation in superscript given indicates significance of difference between states(p<0.05)

* National centre for health statistics (NCHS). (USA), standards

. From the above table it was observed that the mean height of all women in the surveyed villages was similar. The mean weight of women of Andhra Pradesh was found to be high followed by Karnataka.

Mean weight of women was similar in all the surveyed states except Tamilnadu. Average BMI was found to be almost similar among the women in the states of Andhra Pradesh, Karnataka Kerala and Tamilnadu.

Forms of malnutrition of women based on James classification. Based on the height and weight of women, BMI was calculated .. Based on the Body Mass

Index the women were categorized as obese, over weight, normal , low normal, mildly malnourished, moderately malnourished and severely malnourished. The results are presented in table 2, Figs 1 &2

T able 2: p,revalence rates 0 malnutrition In women by gra es 0 f d fBMI Grades of malnutrition

State Total Severe Moderate Mild Low Normal Over obese weight

Andhra Pradesh 100.0 0.6 2.1 8.2 19.4 60.3 9.0 0.4

Karnataka 100.0 0.0 0.0 6.7 30.0 60.4 2.9 ~

Kerala 100.0 6.1 2..4 11.5 17.6 50.9 6.7 4.8 ,

Tamilnadu 100.0 58 8.6 14.5 9.5 32.1 1.5 10.0

Overall 100.0 2.9 4.1 10.5 17 .. 2 49.5 11 .. 6 4.2

so

40

30 ", 20

10

O ·

C Severely mal

DMod.Mal

Mldly mat

Fig 1: Prevalence rates of malnutrltion in women by grades of BMI as suggested by James et el(1988)

10 __ --------------------------~ 60~-------~~----~Pr~--~~ 50~------~--~--~

~ 40~--~----------~~ - 0 30 -i-----:,----.;.-=--~_?.___4 20~----------~ __ ~ 10 .1t-----",,..........,,..,.., O~~~~~~~~~~~~~ .. ~

IOA.P.

WKarnataka

o Kerala

OTamiinadu

Fig 2: States wise forms of malnutrition of fisherwomen based on. James classificatton

It was found that 2..9% of women In the Surveyed states were severely malnourished, 4% were moderately malnourished, 10.5% were mildly malnourished, 17.1% were low normal, 4904% were normal, 11 .6% were over weight and 4.6% of women were obese. Over weight or obesity was more among women of Kerala and Taminadu. Normal were more in Kamataka and Andhra Pradesh than in Kerala and Tamilnadu . Prevalence rates of malnutrition are Yelring between states (p<O.01)

(b) Anthropometrical measurements of Preschool children

Height and weight were measured for all children of below 5 years. These were compared with the standards for given age and weight Gomez classification was utilized for the assessment of various forms of malnutrition. The mean (SO) of height and weight of preschool children is given in Table 3 below:

Table 3: Mean (SO) of height and weight of Preschool children by states

SLNo State Height (cm) Weight (kg)

1 Andhra Pradesh 92" (16.2) 11.6" (3.9)

2 Karnataka 89b (08.6) 12.4b (2.0)

3 Kerala 80c (06.0) 12.0 8 (1.1)

4 Tamilnadu 99d (16.0) 14.8 C (5.2)

5 Overall Mean (SO) 90.6(35.8) 12.7(3.83)

6 Expected height & 98.5 15.4 Weight *

,7 'F' ratio between A • ~ "'1«'"

states (d.f) 82.34(3,966) 41.38(3,966) Note: Figures given are mean (SD) values

• National centre for health studies (NHSC), (USA) , standards

The data show the the overall hejght of the preschool children surveyed in south India was 90.6 cm and their mean weight was 12. 7 kg. All the children are shorter and lower in weight than the standards. Pre school children of Tamilnadu are taller and heavier than other states. Kerala children were shortest, Andhra Pradesh children were with lowest mean heights (p<0.001)

Forms of malnutrition in pre school children

Prevelance rates of malnutrtion by Gomez classification are provided in table 4. Variations in forms of malnutrition between states are significant. Severe forms and moderate forms are more in Andhra Pradesh and Tamilnadu. Mild forms of malnutrition were highest in Karnataka and Kerala. Normals, were very high in T~milnadu and Andhra Pradesh followed by Kerala, Karnataka.

Table 4: Forms of malnutrition of children based on weight for age (Gomez classification)

SLNo. State Sample Forms of malnutrition surveyed Grade - 3 Grade - 2 Grade -I Normal

I (severe) (moderate) (Mild) 1 Andhra 316 (100.0)* 44( 14 .. 0) 82 (26.0) 97 (30.5) 93 (29.5)

Pradesh

2 Karnataka 186 (100.0) - 19 (10.0) 110 (60.0) 57 (30.0)

3 Kerala 215(100.0) 3 (1 .5) 26 ( 12.0) 115 (53.0) 71 (33.5)

4 Tamilnadu 253 (100.0) 18 (7.0) 64 ( 25.0) 80 (32.0) 91 (36.0)

I 5 Overall 970 (100.0) 65 ( 6.S) 191 (19.5) 402 (41.5) 312(32.5)

Note:* 1. Figure given are number (percentages) 2. Variation between states in percentages of malnutrition are significant (X 2 = 109.6, P<O.OO~~

-

so

Grade _III Grade -II Grade -' Normal

Grade of mal nutrion

Fig 3: Forms of malnutritiqn in children by Gomez classification - overall states.

It 1s observed that 6.5% of the preschool children n at! states were severely malnourished I

19.5% were moderately ma~liourishecl, 41 .5% ,of them were mildly malnourished and the remaining 32.5% were normal.

It is clear from the table 4 that 14% of the children in Andhra Pradesh were severely malnourished inspite of the child welfare programmes run by the state government. Hence, nutrition education was given on the nutritive value of the meal given at the anganwadi center. The parents of the preschool children were requested to send their children to anganwadi school.

%

Grade -'II Grade -II Grado _I Normal

Grade of mal nutrion

Cl A-P. • KamattaJ<a 13Korala

• Tamllnadu

Fig. 4: Grades of malnutrition prevailing in states (%)

In Tamil Nadu, majority (36%) of them were normal and the remaining were in different grades of malnutrition. In Karnataka majority (60%) of children were mildly malnourished and 30% were. normal. In Kerala 53% were mildly malnourished and 33% were normal. Nutrition education was provided with emphasis on nutritrative value of meal given at Anganwadi Centre.

Conclusion

Overall, the height and weight of preschool children were 90 cm \3nd 12.7 kg. respectively. Prevalence rates of malnutrition of grade I, grade II and grade III and normal respectively were 41.5,19.5, ~.5 and 32.5. Nutrition education was provided during the survey period.

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